Dambudziko rechiropa rinokanganisa sei itsvo zvakananga: Ngatidzidzei chaizvo nezveHepatorenal Syndrome!

Wakambofunga here kuti dambudziko guru rechiropa rako rinogona kukonzera kuti itsvo dzako dzese dzine hutano hwakanaka dzimire kushanda panguva imwe chete? Ipfungwa inotyisa, handiti? Nhasi tichataura nezvechirwere chakakomba, chinouraya chinogona kuitika kana chiropa chako chikatadza kushanda zvakanaka. Izvi ndizvo zvinonzi navanachiremba Hepatorenal Syndrome (HRS) . Ngationei kuti chii, nei chikaitika, uye zvimwe zvatinogona kuita.

Chii chinonzi Hepatorenal Syndrome?

Zvichitaurwa zviri nyore, hepatorenal syndrome (HRS) chirwere apo chiropa chako chinenge chisiri kushanda zvakanaka, dambudziko guru rinoitika muchikamu chekupedzisira chekutadza kwechiropa. Chinoitika munyaya iyi ndechekuti itsvo dzako dzinongoerekana dzarasikirwa nebasa radzo nekuda kwematambudziko echiropa. Chinokosha ndechekuti izvi zvinoonekwa sekutadza kushanda kweitsvo musati matanga . Izvi zvinoreva kuti unogona kuva nechirwere ichi kunyangwe usina chirwere cheitsvo uye pasina shanduko dzemuviri kana kukuvara kweitsvo dzako. Itsvo dzako dzinogona kunge dzakagwinya zvakakwana, asi nekuda kwedambudziko rechiropa, ropa rinodzipa rinokanganiswa, uye hadzigone kuita basa radzo.

Funga nezvazvo sepombi yemvura iri kushanda zvakanaka, asi kana pombi yemvura ichienda kutangi remvura yakavharwa, mvura haizobudi. Itsvo dziri kushanda zvakanaka, asi matambudziko echiropa anoita kuti tsinga dzeropa dzinotakura ropa kuenda kuitsvo dzivharike uye dzitete. Zvadaro, itsvo hadziwani ropa radzinoda, uye mashandiro adzo anoderera zvishoma nezvishoma. Izvi zvinoonekwa sedambudziko , uye kazhinji, kurapwa kwechigarire kweizvi kungoisirwa chiropa .

Ndiani anonyanya kukanganiswa nemamiriro ezvinhu aya?

Dambudziko iri, rinonzi hepatorenal syndrome (HRS), rinonyanya kubata vanhu vane chirwere chechiropa chakakomba . Zvikuru sei, vanhu vane chirwere chechiropa chisingaperi, chinoramba chichienderera mberi , vane chiropa chave chisisina simba zvishoma nezvishoma nekufamba kwenguva, ndivo vari panjodzi huru yechirwere ichi. Waizviziva here kuti nekuda kwechirwere chechiropa chakadaro kwenguva refu, nyama yechiropa inova nemavanga uye chiropa chinova chakaoma. Tinoti ichi chirwere checirrhosis . Nekuda kwechirwere ichi, ropa rinoenda kuchiropa rinochinja, uye nekufamba kwenguva, chiropa chinomira kushanda.

Uyewo, kana chiropa chako chisina kushanda zvakanaka, izvo zvinoitika kamwe kamwe nekuda kwechimwe chikonzero.Zvisinei, HRS inogona kuitika. Zvidzidzo zvakaratidza kuti HRS inogona kuitika kuvanhu vanosvika 40% vane chirwere chechiropa chinoguma nedanho rekupedzisira. Kunyangwe ichigona kuitika pazera ripi zvaro uye murume kana mukadzi, inowanzoonekwa nevanhu vari muchikamu chechipiri chehupenyu hwavo. Inowanikwawo muvanhu vanosvika 10% vari muchipatara vane chirwere chechiropa chisingaperi kana chakakomba. Kunyangwe paine zvikonzero zvinopfuura chimwe chete zvinokonzera kutadza kushanda kweitsvo nekuda kwechirwere chechiropa, HRS yakasiyana nekuti inoitika kuvanhu vasina chirwere cheitsvo chakamboitika.

Cirrhosis inokonzera sei hepatorenal syndrome?

Iyi inyaya yakaoma zvishoma. Kuchine maonero akasiyana pakati pevaongorori nezvekuti chirwere chechiropa chinokonzera sei hepatorenal syndrome (HRS), kureva kuti, pathophysiology yayo.

Izvi zvinoitika sei chaizvo? (Pathophysiology)

Sezvatinoziva, itsvo dzinotadza kushanda zvakanaka kana tsinga dzeropa dziri muitsvo dzikava shoma, dzikavharika, uye ropa richiyerera richidzikira. Vaongorori vanotenda kuti kudzikira uku kwetsinga dzeropa kunokonzerwa nekusanganiswa kwezvinhu zvine chekuita nechirwere chechiropa uye kutadza kushanda zvakanaka kwechiropa. Chikonzero chikuru cheizvi idambudziko reBP reportal .

Kukwira kweropa muropa rePortal (Portal Hypertension ) chirwere chinokonzerwa nekuwanda kweropa muropa rePortal Vein, tsinga huru inopinda muchiropa, uye tsinga dzinobatana nadzo uye dzinopinda mudumbu, zvichiwedzera. Chikonzero chikuru cheizvi iCirrhosis . Kukwira kweropa muropa kunogonawo kukonzera chirwere chinonzi Cirrhosis cardiomyopathy , chinoita kuti dzimwe tsinga dzemuviri wako dzive dzakafara zvisingawanzoitiki. Kuchinja kweropa uku kwakaoma kunoita kuti dzimwe tsinga dzeropa dziwedzere kukura nepo dzimwe (kunyanya dziri muitsvo dzako) dzichitetepa. Funga nezvazvo sekuzara kwemotokari kune rumwe rutivi rwemugwagwa, izvo zvinokanganisawo dzimwe tsinga.

Ndezvipi zvinhu zvinokonzera kuti mamiriro ezvinhu aya awedzere kuipa?

Kune zvimwe zvinhu zvine chekuita nechirwere chechiropa zvinogona kukonzera HRS. Chinonyanya kuitika iSpontaneous Bacterial Peritonitis (SBP) . Uku kutapukira kwebhakitiriya mudumbu (peritoneum). SBP idambudziko re ascites , inova kuunganidzwa kwemvura mudumbu. Ascites inokonzerwa nekubuda kwemvura mutsinga dzemudumbu nekuda kwe hypertension ye portal.

Fungidzira, kana dumbu rako rizere nemvura (ascites), utachiona hunogona kupinda imomo nyore nyore hwokonzera hutachiona. Ndizvo zvinodanwa neizvi kuti peritonitis yebhakitiriya inongoerekana yaitika (SBP).

Uyewo, BP inogona kukonzera kuti tsinga dzako dzibude nekubuda ropa mudumbu.Kurasikirwa neropa zvakanyanya nekuda kwekubuda ropa mudumbu chimwe chinhu chinokonzera izvi. Kwete izvozvo chete, asi kushandisa zvakanyanya mishonga inobvisa mvura mumuviri , kana kuti "mapiritsi emvura," kunogonawo kuva chikonzero. Mishonga inobvisa mvura mumuviri inoshanda nekubvisa mvura yakawandisa. Vanhu vane chirwere chechiropa chakanyanya vanogona kutora mapiritsi aya emvura kana vaine ascites kana kuzvimba , kunova kuzvimba kwemuviri.

Zviratidzo zvacho ndezvipi?

Vanhu vane hepatorenal syndrome (HRS) vanowanzotanga kunzwa kusagadzikana zvisina kujeka uye kazhinji. Zviratidzo zvinosanganisira:

• Kuneta
• Kusvotwa
• Marwadzo emudumbu
• Kuravira kusina kunaka mumuromo

Pamusoro pezvo, vanogonawo kuva nezviratidzo zvekurwara kwechiropa zvakanyanya kana kuti kutadza kwechiropa. Izvi zvinosanganisira:

• Jaundice (kutsvuka kwemavara machena emaziso)
• Kutsvuka uye kubuda ropa zviri nyore
• Tsvina ine ruvara rwakajeka uye weti ine ruvara rwakasviba
• Kuzvimba kwedumbu (kunokonzerwa neascites, kukura kwechiropa kana spleen)
• Ganda rinokwenya
• Kuvhiringidzika, kurasikirwa nendangariro, kana hope (Hepatic Encephalopathy)

Kana itsvo dzikatadza kushanda zvakanaka, unogona kuona kuti huwandu hweweti yaunoburitsa hwaderera zvakanyanya .

Unozviziva sei izvi?

Hepatorenal syndrome (HRS) imhando yekutadza kushanda kweitsvo kunoitika kana paine chirwere chechiropa chakakomba uye pasina chimwe chikonzero chekutadza kushanda kweitsvo. Saka, vanachiremba vanoongorora izvi nekutanga vasimbisa chirwere chechiropa nekutadza kushanda kweitsvo, vozobvisa zvimwe zvinokonzera kutadza kushanda kweitsvo. Kuti vaite izvi, vanoshandisa bvunzo dzakasiyana-siyana dzemifananidzo , dzakadai sekuskena, kuongororwa kweropa, uye bvunzo dzeweti, kuti vaone kuti chiropa chako neitsvo zviri kushanda sei.

Inorapwa sei?

Kunyange hazvo HRS iri chirwere chakakomba nekuda kwekutadza kushanda zvakanaka kweitsvo, mudzi wedambudziko iri muchiropa . Hepatorenal syndrome (HRS) inorongwa se "prerenal" yekutadza kushanda zvakanaka kweitsvo nekuti itsvo dzako dzine hutano hwakanaka. Kutaura zvazviri, kana itsvo dzako dzikatorwa dzikaiswa mumuviri wemumwe munhu, dzichashanda zvakanaka. Saizvozvowo, kana mashandiro echiropa chako akadzoka pakushanda zvakanaka, pane mukana wekuti itsvo dzako dzichatanga kushanda zvakare.

Vamwe vanhu vane chirwere chechiropa chakakomba vanogona kupora kushanda kwechiropa neitsvo. Asi vamwe vese vachada kuisirwa chiropa . Vangada kuisirwa chiropa pane imwe nguva, asi HRS inoita kuti chinodiwa chive chekukurumidzira. Zvisinei, havasi vese vanokodzera kuisirwa chiropa, uye kunyangwe vakadaro, vanofanirwa kumirira kusvika vawana chimwe.

Panguva yakaita seiyi, kurapwa nekukurumidza uye kutarisirwa kwakakodzera ndizvo zvinhu zvinonyanya kukosha.

Panguva iyi, chiremba wako kana mukoti achaedza kuchengetedza mashandiro eitsvo dzako zvakanyanya sezvinobvira uye kuderedza zviratidzo nemigumisiro yechirwere ichi. Matanho aya anogona kuvandudza hutano hwako hwese uye kukubatsira kugadzirira kuisirwa chiropa. Anogonawo kubatsira kuvandudza mhedzisiro yekuisirwa chiropa kana uine chimwe. Zvisinei, aya haasi mushonga . Mishonga iyi inogona kusanganisira:

• Mvura yemutsinga , inova zvinhu zvakaita semunyu, inopihwa kugadzirisa kusawirirana kwema electrolyte mumuviri uye kubatsira kuyerera kweropa kuenda kuitsvo.
• Kurega mimwe mishonga, yakaita semapiritsi emvura ( diuretics ).
• Kupa mishonga inorwisa utachiona inosanganiswa nayo.
• Paracentesis inoitwa kubvisa mvura yakawandisa yakaunganidzwa nekuda kweascites.
• Kupa mishonga inonzi vasoconstrictors . Iyi inoshanda nekuderedza tsinga dzeropa dzisina kupararira zvakanyanya uye kuwedzera kuyerera kweropa kuenda kuitsvo.
• Hemodialysis , iyo inonzi blood dialysis, inzira yekurapa itsvo dzako dzine dambudziko.

Zvingadzivirirwe here?

Nzira yakanakisisa yekudzivirira chirwere chehepatorenal syndrome (HRS) ndeyekutarisira chirwere chechiropa chisati chakura kuita cirrhosis . Chirwere chechiropa chisingaperi chirwere chinokura zvishoma nezvishoma kwemakore mazhinji. Vanhu vanoziva kuti vane chirwere ichi vanogona kudzora uye dzimwe nguva kudzora kufambira mberi kwechirwere nekuita zvinhu zvakaita sekuderedza doro, kuderedza huremu, uye kuvandudza kudya kwavo. Zvisinei, nekuti vanhu vazhinji havaratidzi zviratidzo, chingasaonekwa pasina kuongororwa nachiremba nguva dzose.

Kana uchitova nechirwere checirrhosis, hapana nzira yekufungidzira kana kudzivirira HRS kuti isatange. Zvisinei, chirwere cheSpontaneous Bacterial Peritonitis (SBP)Zvisinei, unogona kudzivirira "chinokonzera" chinowanzoitika cheizvi. SBP ndiyo inokonzera inenge 25% yezviitiko zveHRS muvanhu vane cirrhosis. Saka, kana chiremba wako achifunga kuti uri panjodzi huru yeSBP, kutora mishonga inorwisa mabhakitiriya senzira yekudzivirira kunogona kuderedza chinokonzera ichi uye kuderedza mikana yako yekuva neHRS.

Izvi zvinogona kurapwa here? Zvinoisa upenyu panjodzi here?

Pasina kuisirwa chiropa, vanhu vazhinji vanenge vari mumamiriro ezvinhu akaoma zvikuru. Kana HRS ikangoerekana yaipa uye pasina kuisirwa chiropa, avhareji yenguva yekurarama imavhiki maviri chete. NeHRS isingaperi, avhareji yenguva yekurarama pasina kuisirwa chiropa imwedzi mitatu kusvika mitanhatu . Zvichienderana nekuti chiropa chakanyanya sei, mamiriro acho anogona kukurumidza kuipa. Uyewo, kana mamiriro acho akakurumidza kuipa, unogona kurwara zvakanyanya zvekuti haugone kuisirwa chiropa, izvo zvinogona kuoma.

Zvisinei, kana ukaisirwa chiropa, mamiriro ako ezvinhu achave nani zvikuru . Vanhu vane HRS vane mukana we60% wekurarama makore matatu mushure mekuisirwa chiropa. Izvi zvakaderera zvishoma pane mwero wekurarama kwemakore matatu wevanhu vanowanzoisirwa chiropa (75%). Kushanda kweitsvo kwevanhu vazhinji kuchadzoka pakushanda kwakajairika mukati memavhiki mashoma. Nhamba diki kwazvo (inenge 5%) ingangoda kuramba ichiongororwa .

Ungave uri munhu ane dambudziko rekutadza kwechiropa zvishoma nezvishoma kana kuti wakangoerekana watanga chirwere chehepatorenal syndrome (HRS) chakakukurumidzisa nguva yako, kuva pane runyorwa rwevanhu vanopa chiropa hachisi zano rakanaka. Nekuti hapana zviropa zvakakwana zvevanhu vari pane runyorwa irworwo. Zvisinei, kana ukakwanisa kuwana munhu anopa chiropa ari mupenyu , ungasafanira kuva pane runyorwa, uye hutano hwako hwese hunogona kuvandudzika.

Vanopa vari vapenyu vanozvipira vane hutano, kazhinji vadikanwi vako, vanoenderana nerudzi rweropa rako nehukuru hwemuviri wako. Kunyangwe chidimbu chidiki chechiropa chakatorwa kubva kune mumwe munhu mupenyu chinogona kukura zvakare kuita chiropa chakazara mauri nemupi wacho. Zvakare, zviropa zvipenyu zvinogona kunge zviri mumamiriro akanaka pane zviropa zvakatorwa kubva kune vakafa vanopa. Vanachiremba vanovhiya vanoedza nepese pavanogona napo kuti kuvhiyiwa kwevanopa vari vapenyu ava kuve kushoma sezvinobvira.

Pakupedzisira, zvinhu zvekurangarira

Saka, pamwe wava kunzwisisa kuti hepatorenal syndrome chirwere chakakomba chinoda kutarisirwa nekuti chinokanganisa itsvo nekuda kwematambudziko echiropa.

• Hutano hwechiropa hwakakosha zvikuru:Kana uine chirwere chechiropa, zvakakosha kuti uchitarisire zvakanaka, kunyanya kudzivirira kuti chisapfuurire kusvika pakuva chirwere checirrhosis.
• Nyatsoteerera zviratidzo: Kana uine zviratidzo zvine chekuita nechirwere chechiropa kana kunzwa kusanzwa zvakanaka, enda kuna chiremba nekukasika.
• Funga nezveitsvo dzako: Kana uine matambudziko echiropa, unofanirawo kutarisira itsvo dzako. Kana uine zviratidzo zvakaita sekudzikira kweweti, udza chiremba wako.
• Kune kurapwa: Kunyange hazvo HRS iri chirwere chakakomba, kurapwa kwakadai sekuisirwa chiropa kunogona kuponesa hupenyu. Saka usarasa tariro.
• Mararamiro akakosha: Zvinhu zvakaita semararamiro ane hutano, kudya zvine mwero, uye kusanwa doro zvinobatsira kuchengetedza chiropa chine hutano.

Ndinovimba ruzivo urwu ruchakubatsira. Kana iwe kana mumwe munhu waunoziva ari kusangana nedambudziko rakadai, chinhu chakanakisa chekuita kutsvaga rubatsiro rwechiremba nekukasika.

Hepatorenal syndrome, chirwere chechiropa, kutadza kushanda kweitsvo, cirrhosis, kuisirwa chiropa, portal BP, ascites